Kawirikawiri mankhwala a ARDS
Kuchiza kwa ARDS
ARDS, kapena kupuma kwapachipatala matenda, ndi vuto lalikulu la kupuma lomwe lingayambitse matenda oopsa. Matenda oyambirira ndi mankhwala ndi ofunika kwambiri kuti asiye ARDS isanafike povuta kwambiri kuti chiwonongeko cha thupi kapena imfa ipewe. Kuyezetsa magazi ndi matenda ndi kofunikira kuti apulumutse moyo wa wodwala amene ali ndi ARDS.
Njira Zodziwika Kwa ARDS
Oxygen: Chithandizo chimayamba mwa kupereka okosijeni wodwalayo kuti athandize kukhala ndi mpweya wabwino m'magazi. Izi zimachitidwa ndi intubating wodwala ndi kugwiritsa ntchito mpweya wabwino . Izi zimapangitsa wodwalayo kupuma, ngakhale atakhala wofooka kuti asapume yekha, ndipo amatha kupereka mpweya wochuluka kusiyana ndi umene umapezeka ndi chingwe cha pakhosi kapena nkhope ya maski.
Maantibayotiki: Mankhwala ophera antibiotics amaperekedwa kwa odwala a ARDS chifukwa cha matenda , monga chibayo, kapena matenda ena. Matenda ambiri a ARDS amayamba ngati chibayo kapena chifuwa chibayo, kupanga maantibayotiki ofunika.
Mankhwala a IV: Madzi amathandiza kwambiri thupi kumathandizira ntchito zake zonse, koma kupeza madzi okwanira kungakhale kovuta. Madzi aang'ono kwambiri ndipo thupi limakhala lopanda madzi, zimapangitsa kuti zikhale zovuta kutumiza magazi okwanira ndi mpweya ku ziwalo ndi mapeto. Madzi ambiri amatha kulepheretsa mphamvu ya m'mapapo kuti iwononge magazi.
Kuika Thupi: Nthaŵi zina zimatha kuthandizira mpweya kuti wodwalayo agone m'mimba mwake. Koma, odwala ambiri a ARDS amadwala kwambiri moti ngakhale kusintha kochepa pa malo kungapangitse kuti vuto lawo likhale loipitsitsa, lomwe limapangitsa kuti maitidwe ndi antchito akhale ovuta kwambiri. Bedi limene limatembenuza wodwala kuti alowe m'mimba mwawo kulola kuti IV zothandizira ndi zowonjezera zowonjezera kupitilira ndi gawo lofala la mankhwala.
- Onani RotoProne, bedi limene amagwiritsidwa ntchito pochiza ARDS ndi matenda ena opuma. Kuwoneka kwa bedi sizodabwitsa kwambiri ndipo kungakhale koopsya kwa mamembala pamene akuwona wokondedwa wawo mmenemo.
Kusakaniza Mankhwala:
- Oxydi Yamititi: Wowonjezera Mavitamini a Nitric, kapena INO, ndi gasi losaoneka bwino komanso lopanda phokoso lomwe nthaŵi zina limaperekedwa ngati mankhwala kwa odwala a ARDS. Amapereka kusintha kwa kayendedwe ka pulmonary, zomwe zimawonjezera mpweya wabwino. Zofufuza sizodziwika ponena za mphamvu ya INO.
- Albuterol: Mankhwala osakaniza, albuterol amagwiritsidwa ntchito pochizira matenda a mphumu mwa kutsegula bronchus. Angagwiritsidwe ntchito pochiza ARDS kuti atsegule mpweya.
Steroids: Utsogoleri wa ma ARVs kwa odwala omwe amapezeka ndi ARDS ndi nkhani yotsutsana kwambiri pankhani ya mankhwala. Madokotala amagawanika ngati steroids ndi mankhwala othandiza a ARDS.
Levophed: Mankhwalawa amaperekedwa kuti athetse mphamvu ya magazi mwakumangirira mitsempha ya thupi. Odwala ambiri omwe ali ndi ARDS amavutika kuti azikhala ndi magazi awo; mankhwalawa amapereka chithandizo cha magazi ndipo ndi mankhwala osankhidwa kwa odwala omwe ali operewera komanso omwe ali ndi vuto lopuma.
Okhaokha ndi Osowa Ziwalo: Zomwe zimaperekedwa zimathandiza kuti wodwalayo akhale chete ndikuwathandiza kulekerera kukhala pa mpweya wabwino, zomwe zingayambitse nkhawa zambiri. Odwala ziwalo, kapena mankhwala osokoneza bongo omwe amachititsa kuti thupi likhale lopweteka kwambiri, limagwiritsidwa ntchito pamene wodwala akulimbana ndi mpweya wotsegula mpweya kuti apange mpweya wabwino kuti uchite ntchito yake. Odwala ziwalo samagwiritsidwa ntchito popanda dothi, koma sedation ingagwiritsidwe ntchito popanda olumala.
Wosagwira ntchito: Wosagwira ntchito ndi opangidwa ndi mafuta ndi mapuloteni omwe amapezeka pa alveoli (air bags) m'mapapu. Wogwira ntchitoyi amathandiza ntchito ya alveoli, kupititsa patsogolo mpweya wabwino.
Munthu amapanga surfactant nthawi zambiri amapatsidwa kwa ana asanakwane, omwe sangakhale akupanga zokwanira. Mankhwala omwewa amaperekedwa kwa odwala ARDS nthawi zambiri.
Pambuyo pa ARDS
Pomwe wodwala atapezeka kuti ali ndi ARDS, chiwerengero cha anthu akufa chimakwera pafupifupi 40%, kutanthauza kuti odwala anayi mwa khumi aliwonse ali ndi ARDS amafa. Odwala omwe amapulumuka kawirikawiri amatero chifukwa amapezeka kuti ali oyambirira komanso amachiritsidwa kwambiri ndi mankhwala oyenera. Ngakhale kuti nambalayi ndi yovuta, chithandizo cha ARDS chimakula chaka chilichonse, ndipo odwala ambiri akupulumuka.
Ndi zachilendo kukhala wotopa, kupuma pang'ono ndikudwala pambuyo pa ARDS. Zitha kutenga masabata kapena miyezi kuti izidziwike bwino, ngakhale atachotsedwa kuchipatala. Kwa odwala ena, kupweteka kwa mapapo kungatanthauze kuti oxygenation si yabwino monga idali isanayambe matenda, ndikupweteka.
Zotsatira:
Kutulutsa Oxydi Yamitini Kwa Matenda Aakulu Achikulire Opuma Opuma. The New England Journal of Medicine. Idapezeka mu January 2011. http://www.nejm.org/doi/full/10.1056/NEJM199307153290313
Kuchiza kwa Odwala Odwala Mliri Woopsa / ARDS Wapita Pakati pa Nthawi. M. Zambon, J. Vincent. Chifuwa: Journal of the American College of Lung Physicians. July 2008.
Kodi ARDS n'chiyani? National Heart Lung ndi Magazi Institute. Idapezeka mu January 2011. http://www.nhlbi.nih.gov/health/dci/Diseases/Ards/Ards_WhatIs.html